Capecitabine-induced bilateral ectropion: A rare ocular manifestation requiring surgical intervention

Abstract

It has been established that many chemotherapeutic agents are associated with a variety of ocular side effects. As an antineoplastic agent, 5-fluorouracil (5-FU) is the chemotherapeutic agent that is frequently linked with cicatricial ectropion. Capecitabine is a prodrug of 5-FU and has a more favorable side effect profile than 5-FU. Frequent side effects of capecitabine include gastrointestinal events and hand–foot–mouth syndrome; cicatricial ectropion is rather uncommon. Enzyme deficiencies affecting the capecitabine metabolism have been reported to be associated with exaggerated generalized systemic and cutaneous side effects; however, there are no cases in the literature reporting capecitabine-induced isolated bilateral-progressive ectropion. Although cessation of the agent is frequently sufficient for the treatment of ectropion, close follow-up is indicated in such patients as permanent damage may occur if the problem is left untreated. We report a case of capecitabine-induced bilateral cicatricial ectropion refractory to treatment cessation, ultimately requiring surgical treatment.

Conjunctivitis associated with capecitabine treatment in a patient with colon cancer: The importance on educating patients into identifying adverse reactions

“…The progression of corneal and conjunctival symptoms after discontinuation of capecitabine and the absence of adequate improvement with topical conservative therapy directed to surgical management. 11 Time to onset of ophthalmological symptoms following the administration of capecitabine is variable. In our case, it developed after 20 cycles receiving capecitabine.…”

“…The progression of corneal and conjunctival symptoms after discontinuation of capecitabine and the absence of adequate improvement with topical conservative therapy directed to surgical management. 11…”

Treatment of Capecitabine Corneal Side Effects With Autologous Blood-derived Serum Eye Drops

“…Complete resolution of the corneal lesions has been observed following the interruption of the treatment with C in both dogs and human patients (5). Only one ocular adverse effect has been reported to be refractory to treatment cessation: a case of Cinduced bilateral cicatricial ectropion, which has required a surgical approach (7). Interestingly, L seems to affect VEGF, one of the most important proteins in corneal neovascularization (CN).…”

Capecitabine‐induced bilateral ectropion on a patient with paraneoplastic dermatomyositis

“…6 The other reported case shows a bilateral ectropion with a progressive and more insidious onset that does not respond to conservative measures, and therefore surgical intervention was promoted. 7 An explicitly multidisciplinary approach is essential, especially for cases associated with systemic conditions, as the case reported. The therapeutic aim must be based on the suspension of the capecitabine and the decision of a topical, systemic and even surgical treatment should be imposed by consensus among specialists and considering the general condition of the patient.…”